Sample clinic bill
  1. Header on the bill

    “Statement of Physician Services” tells you this is a clinic bill. If the name of a hospital appeared in this space, it would be a bill for a hospital visit.

  2. Account number

    This is your account number. You will need this to pay the bill online or inquire about it with Customer Service 877-576-3544.

  3. Name and address

    The name and address of the person responsible for paying the bill. If this isn't current, please notify Customer Service or your clinic.

  4. Service date

    This is the date you visited the clinic or went for tests.

  5. Description & transaction date

    This will show the name of the doctor and clinic, the reason for the visit, the history of the date you or your insurance company were billed, and payments and discounts received.

  6. Pending insurance

    This is an estimate of how much we expect to receive from your insurance company. It is not a guaranty and could change depending upon decisions made by your insurance company.

  7. Current patient responsibility

    At the bottom of each listing for specific service dates is a summary of what you owe. That is the total left after all insurance payments and discounts have been applied.